Parents often read to their two year old and four year old simultaneously. Early childhood teachers read to their students every school day. When reading to a group of children, it is vital that you are familiar with the text. You may wish to take a moment to think about open-ended questions you can ask children before you begin a story. For example, if you were to be reading Bear Snores On by Karma Wilson, you could ask “Does anyone know what bears do all winter long?” If you get a response such as “sleep” or “hibernate,” great! If you do not get a response, inform the children. Giving them a glimpse into the story will enhance their understanding and appreciation.

Ask questions during the story. Perhaps there is a vocabulary word the children might not be familiar with. In the book Don’t Let the Pigeon Stay up Late by Mo Willems, the pigeon insists the children listening to the book let him stay up so he can watch an educational program on television. You can ask, “What does educational mean?” You can also explain to the children how the pigeon is trying to “trick” (manipulate) them into letting him stay up late. Then, ask the children “How have you tried to trick your parents?”

At the conclusion of a story, ask children to carry over a main theme from a book into their daily lives. For example, after reading My Friend Rabbit by Eric Rohmann, ask the children “What does it mean to be a good friend?”

Adding props and puppets to group story time can engage kids with various levels of attention. In Caps For Sale by Esphyr Slobodkina, the peddler walks around carrying many caps on his head. The children can do the same with caps that you have previously collected for story time, or they can use their winter hats, or caps that they make as an art project to accompany the theme of the book.

Using different voices and revealing the characters’ emotions while acting out the story can also help children attend and relate more effectively. The mother dog in Bark, George by Jules Feiffer gets frustrated with her son, while he makes great animal sounds. The children will laugh when you over-act the role of George, his mother and especially the veterinarian reaching deep down into George’s mouth to pull out all the animals he has consumed.

Children are inspired to verbally participate when their peers say the repetitive line in a story together. In Tikki Tikki Tembo retold by Arlene Mosel, the older brother’s name is Tikki tikki tembo-no sa rembo-chari bari ruchi-pip peri pembo. Opportunities to say this long name come up numerous times, sometimes fast, sometimes slow, and children listening will want to try to say the name along with you.

Always read the title, author and illustrator’s names. Ask the children “What is an author?” “What is an illustrator?” Provide the information accordingly. If the author has written other books the children may be familiar with, ask them “What other books has this author written?” If necessary, name one or two of the books and you may notice how excited the children become when they realize they have shared a previous experience with you.

If you need help choosing the right books based on your child’s needs, you can ask your speech therapist, child’s teacher or librarian.

This article was written by Stephanie Sigal M.A. CCC-SLP.  It appeared today on the American Speech-Language-Hearing Association (ASHA) blog, ASHAspere.

Stephanie Sigal, M.A. CCC-SLP, is a speech language therapist practicing on the Upper East Side of Manhattan, NYC. She works with babies, toddlers and school age children with expressive language delay and articulation disorders. Stephanie provides home based speech therapy and encourages parents to facilitate their children’s speech and language skills. To learn more about Stephanie, please visit sayandplayfamily.

Reading books with your child can provide experiences and vocabulary that he or she may not be exposed to on a daily basis. Experience allows children to gain understanding. When a child understands vocabulary and situations, he or she has the foundation to use these words in verbal language.

Always read with your child face to face with the book next to your face, not in front of your mouth. This will allow your child to see how you move your mouth when you say words, see your facial expressions and engage in eye contact. With a baby, you can create this opportunity while he or she is on the change table, floor, car seat, bouncy chair or on your thighs facing you.

Reading with your child everyday should start from birth. At this time, you can read anything to your son or daughter, even The New York Times. What matters is HOW you read it. Read with feeling, show emotion and pause to allow your baby to vocalize back to you.

Initially, choose books with a story and meaning. Vocabulary board books (e.g., books by Roger Priddy or select DK Publishing books) will be boring for you and not provide much benefit for your baby. Reading longer stories during the first months will help to build your child’s attention. Books like The Three Bears by Byron Barton, Summer by Alice Low and Chewy Louie by Howie Schneider will be fun for you and your baby.

If your toddler has trouble paying attention to a book, try reading when he or she is “trapped” (e.g., in the highchair eating, in the car seat while traveling, just waking up from a nap in the stroller). I once worked with a two year old boy who would only happily pay attention to an unfamiliar book while standing in his crib facing me. Once he became familiar with a book, we could read the book elsewhere.

Choosing the right books can help target speech and language skills you want to develop.

If your child is not talking, choose books that contain words that begin with bilabial sounds. These are sounds where your upper and lower lips come together (/m/, /b/ and /p/). Bilabial sounds are generally early sounds produced by children because they can see how an adult is moving their lips, which is helpful for imitation. Favorite books that include bilabial sounds are It’s Not Easy Being a Bunny (Marilyn Sadlow), The Berenstains’ B Book (Stanley and Jan Berenstain) and any book that contains animal sounds (moo, baa, maa). Overemphasize /m/, /b/ and /p/ and make eye contact with your child when saying bilabial sounds in any book.

Selecting books with repetitive phrases may allow your child to participate during story time. Great examples include: Dear Zoo (Rod Campbell), The Very Busy Spider (Eric Carle) and The Gingerbread Boy (Richard Egielski). Give your child the opportunity to complete the repetitive line, or if he or she is ready, the whole line. Hopefully, these words will carry over into daily vocabulary.

Rhyming books help children with word prediction, which is crucial for reading development. Once familiar with a rhyming book, have your child try to fill-in the rhyming word. Dr. Seuss’ The Foot Book begins: Left foot, Left foot, Right foot, Right – Feet in the morning, Feet at _____ (child should say “night”).

If your child’s speech therapist has determined that understanding and using prepositions is an important goal for your child, use books to reinforce what occurs in therapy. Trashy Town by Andrea Zimmerman and David Clemesha, Up Above and Down Below by Sue Redding and Around the House the Fox Chased the Mouse by Rick Walton are all loaded with prepositions.

A child with more developed language who has difficulty providing details and descriptions may benefit from “reading” wordless picture books to you. Pictures in the story should be described so that the story makes sense. You can use picture books with text, as long as the pictures are detailed themselves. (You may cover the text with your hand if your child can read.) This works best with Caldecott Medal / Honor Books. Excellent examples include Knuffle Bunny books (Mo Willems), No, David! (David Shannon) and Where The Wild Things Are (Maurice Sendak).

Other favorite wordless picture books include A Boy, a Dog and a Frog Series by Mercer Mayer, Pancakes for Breakfast by Tomie DePaola and The Jack Series by Pat Schories. If you feel your child leaves out important information, ask an open-ended question (e.g., “Ooo – What’s happening over here?”). Provide a description if you feel this is too challenging. Perhaps this will increase your child’s awareness to be more specific and when you sit down to read the book again, the new information will be included.

Sometimes it is helpful if you “read” a wordless picture book to your child first. Describe what you see or make-up the story-line. For example, when David, the main character in the book No, David! is about to fall off the chair while reaching for a cookie, you can say: “Be careful David, you’re going to get hurt!” or “No cookies before dinner!!”

Look for Part Two Coming Soon:  Encouraging Speech and Language Skills while Sharing Books with a Group of Children
 
This article was written by Stephanie Sigal M.A. CCC-SLP.  It appeared today on the American Speech-Language-Hearing Association (ASHA) blog, ASHAsphere.

May is Better Speech and Hearing Month.  Ever wonder what a pediatric speech therapist notices when she is walking the streets of Manhattan?  Children, their parents, caregivers, and sometimes, bad communication habits. 

What did I see this week?

1. A pacifier in a toddler’s mouth while he was happily walking around the playground.  He clearly wasn’t using the pacifier to sooth himself.  How could he even try to speak to a potential playmate?

2. I turn around to find a nanny named Katie speaking to her two year old ward Johnny.  She asks “Can Johnny throw the ball to Katie?”  If Katie used pronouns (e.g., Can you throw the ball to me?), Johnny would learn to use pronouns.

3. A parent sitting on a park bench complaining on her cell phone about her Mother-in-Law, while her adorable 6ish month old girl tries to get her attention.  You will never win with Mother-in-Law.  Why not use that precious time to speak with your baby, teach her something new and strengthen your bond?  Same goes for listening to your ipod, watching television and catching up on your emails.  Try to turn off technology and tune into your child.

4.  Eating at a sidewalk cafe, a young boy refuses to stay seated.  His dad tells his son ”You’re not going to get any lunch if you don’t sit down!”  Is he really not going to feed his child?  Empty threats are the worst, and everyone seated around you knows it too.  Effective communication with your child is critical.  Say what you mean and mean what you say!

5.  I’m waiting for the light to change and a man jogs up with his ipod blaring.  I am concerned for his hearing and safety.  I can hear Jennifer Lopez singing Let’s Get Loud.  She sings:

…You gotta prove it
You gotta mean what you say

Maybe he was playing his ipod loudly for the dad at the sidewalk cafe?

6. Have you ever seen a child too old to drink from a bottle using one?  When a child continues to use a bottle (or sippy cup or pacifier) past age one, he may develop a tongue thrust / lisp.  Step into any kindergarten classroom and you will quickly notice a number of children with tongue thrusts.

7.  In the bookstore, turned rainy day escape destination, an ambitious mother reads an exciting book to her son.  She has him so engaged in the story it’s impressive.  He starts to tell her something about the story and the mom says “Wait!  There’s more!  Listen to the whole story Adam!”  Poor Adam, he had something important to share.  Another missed communication exchange.
 
8. Also in the children’s section, Thomas the Train is up on a high shelf.  A little boy points toward Thomas.  Grandma, well intentioned, involved, and well-versed in Thomas the Train lingo isn’t sure if he is pointing to Thomas, James or Percy?!  Grandma points to Thomas and asks “Do you want this?” The boy shakes his head.  “Do you want this?” as Grandma points to James.  “NO!” says the boy.  “Oh, you must want THIS!”  Grandma then hands Percy to her grandson, who has been deprived of an opportunity to try to use the names of the trains and deprived of learning how to make a verbal request instead of just pointing.  Next time grandma could try offering choices.

9. I hop into the elevator with a mom, her toddler and another woman.  The woman speaks directly to the toddler and asks “What ‘s your name?”  The mother responds “Joe.”  The woman asks “What are you eating, Joe?”  The mom replies “A cracker, right Joe?”  Give your child an opportunity to participate in spontaneous conversation.   Afterall, the woman didn’t want to talk to you, she wanted to talk to your cute baby.

Hopefully this information has improved your awareness about communicating with your child.  If you feel you would like personalized strategies to maximize communication exchanges with your child, please email me and we can set up an appointment.  I work with children and their families in their homes on the Upper East Side of Manhattan.

A speech therapist recently wrote to me about a child she is working with. Some of the information has been edited for privacy purposes.

Question: Stephanie, I am working with a 6 year old boy who is drooling. He had his adenoids recently removed. His parents have noticed a decrease in his drooling, but the problem still persists.

He does not have open lip posture, his top teeth slightly protrude and he swallows nicely on command. His awareness of his excessive saliva is poor. This saliva impacts his articulation. When he swallows, his speech (articulation and vocal quality) are more intelligible.

What can I do to help this student? Any specific oral motor exercises you recommend?

Answer: Take a look at his tonsils. I’m wondering if he has a tongue thrust since you noticed his top teeth are protruding. The tongue thrust may be occurring for a variety of reasons, including large tonsils (the tongue will be misplaced anteriorly if the tonsils take up too much room posteriorly).  If you feel his tonsils are enlarged, it may be appropriate to revisit the pediatric otolayngologist (ENT). 

If you are in NYC, you can find a list of pediatric ENT’s here.

As with any oral motor work, you have to start from the bottom-up. Make sure his body posture and jaw are strong and stable, then the tongue, and finally the lips. Weakness at any of these levels needs to be addressed. Have you taken any good oral motor courses?  Try renting Talktools / Sara Rosenfeld Johnson’s level one class to get started, if you feel this is an area you need experience.  Once you know his jaw, lips and tongue are strong and stable, here are some Ideas To Eliminating Drooling:

1. Help him become aware of his mouth

2. Improve his swallowing frequency and efficiency (he needs to fully retract the saliva)

3. At rest, his lips should always be closed

Talk to him about wet vs. dry mouth, lips and chin to build his awareness.  Have him wear terrycloth wristbands. Ask him to wipe his lips and chin when they are wet.  Each time he wipes his lips and chin, he should be reminded (until he does this independently) to swallow. You may need to teach him the concept of swallow.  Wristbands will also act as a visual reminder to dry his face and to swallow.  Purchase a few pairs as they need to be washed daily.

If you or his parents do catch him with lips apart, remind him to keep his lips together, especially at rest and when he is actively involved in a task. Can he keep his lips closed during a fine motor task?

To help him build awareness of his lips, have him put on flavored Chapstick, make “raspberries” and smack his lips. If it is safe to, and he can tolerate vibration, use a gentle, child-sized battery operated toothbrush to brush his teeth, inside of his cheeks and tongue. With firm (not too hard / not too light) pressure, run the toothbrush over his lips, to stimulate them / make him more aware.

Good luck – please let me know if you have more questions.

P.S. Should you actively work with this child for 4 weeks (and speech homework is consistently practiced) and improvement is not observed, a follow-up pediatric ENT visit is critical.

Stephanie Sigal, M.A. CCC-SLP is a New York State and ASHA certified Speech and Language Therapist.  She works with children with articulation and language delay, as well as with children that drool and suck their thumbs on Manhattan’s Upper East Side.  You can contact Stephanie at sayandplay@yahoo.com.

Please help protect your child from a noise-induced hearing loss by teaching three basic principles:

1. Keep the volume down on the ipod or mp3.  Encourage half volume.

2. Limit listening time.

3. Model good listening habits.

Learn how to watch for warning signs of hearing loss.

Help your child prevent a hearing loss.  A hearing loss is not reversible.

Even a mild hearing loss can affect a child’s ability to pay attention in the classroom, speech and language skills, social interaction and behavior. 

Help your child to learn good listening habits!